Comparison of EMG Activity during Trunk Forward Bending with and without Limited Lumbar Flexion Angle

Soo-Hyun Bae(Soo-Hyun Bae),Duk-Hyun An(Duk-Hyun An),Jae-Seop Oh(Jae-Seop Oh),Won-Gyu Yoo(Won-Gyu Yoo) 한국임상움직임치료학회 2022 한국임상움직임치료학회지 Vol.2 No.1

Background: Several studies have evaluated the relationship of low back pain with lumbar flexion angle and muscle activity. However, there are scant studies on the relationship between the ratio of normalized muscle activities and lumbar flexion angle. The lumbar flexion angle has been used to diagnose low back pain and to determine the predominantly used muscles during trunk forward bending in asymptomatic individuals. Prolonged sitting is associated with a slumped or upright sitting posture, which can affect the soft tissues in the lumbar region. Objectives: The purpose of this study was to determine the predominantly used muscles during forward bending, holding, and re-extension based on EMG data. Methods: In total, 20 participants were screened for inclusion. The activities of the longissimus [ES (T12)], erector spinae [ES (L3)], gluteus maximus, and hamstring muscles were examined during forward bending, holding the posture, and re-extension. The mean lumbar flexion angle was used to categorize the patients. Patients with a short hamstring length during forward bending were excluded. Results: The ES (T12) and gluteus maximus : hamstring, and ES (L3) : hamstring activity ratios were compared between the groups during the three phases. The data were normalized to calculate the percent reference voluntary contraction (%RVC). The gluteus maximus : hamstring and ES (L3) : hamstring ratios during re-extension were significantly different between the groups. Conclusions: In the experimental group, the participants showed greater activation of the hamstrings than the gluteus maximus and erector spinae during re-extension. Future studies should include a larger sample size and use more precise eligibility criteria.

Ultrasound Characteristics of The Abdominal Muscle Thickness during Prone Hip Extension Test in Subjects with and without Lower Back Pain

Eui-Ryong Kim,Byeong-Jin Kim,Won-Nyeong Cho,Min-Joo Ko 한국임상움직임치료학회 2023 한국임상움직임치료학회지 Vol.3 No.2

Background Deep abdominal muscles have a stabilizing role in the lumbo-pelvic region both increasing intra-abdominal pressure and lateral tension on thoracolumbar fascia. Prone hip extension (PHE) is commonly used as a reliable self-perturbation task to test lumbopelvic stability. To our knowledge, no study has directly evaluated abdominal muscle thickness with and without lower back pain (LBP) using ultrasound measurements during the PHE test. Objectives The purpose of the present study is to investigate the changes in the thickness of the trans-verse abdominis (TrA), internal oblique (IO), and external oblique (EO) during PHE using USI in subjects with and without LBP. Methods Seventy-three subjects (37 with LBP, 36 without LBP) were allocated. Three repeated ultra-sound imaging (USI) measurements were recorded in the prone resting position and during the PHE test in a day. Ultrasonography was used to determine the task-related changes in the thickness of abdominal muscles at resting and during the PHE test. Results The muscle thickness of the TrA and IO in the LBP group was significantly lower compared to without the LBP group during the PHE test (p < 0.05). While, the muscle thickness of the EO in the LBP group was significantly greater compared to without the LBP group during the PHE test (p < 0.05). Conclusions Our findings indicate that Individuals with LBP was lower muscle thickness of TrA and IO and greater muscle thickness of EO compared to the without LBP group. The findings of this study may be useful data for comparing the effects before and after exercise on muscle thickness of TrA, IO, and EO in LBP and planning treatment.

탄력 밴드를 이용한 첫 번째 발허리발가락관절의 폄과 발목 발등굽힘의 증가가 발목관절 안정성에 미치는 효과

안나원(Na-Won An),이은창(Eun-Chang Lee),오재섭(Jae-Seop Oh) 한국임상움직임치료학회 2022 한국임상움직임치료학회지 Vol.2 No.2

Background It is known that ankle stability is required to maintain balance. However, metatarsophalangeal joint movement is related to ankle stability, there is no study that increases the first metatarsophalangeal joint extension and ankle dorsiflexion affect together in ankle stability. Objectives The purpose of this study was to determine the effect of an elastic band on ankle stability during one leg standing on an unstable surface. Methods A total of 12 healthy adult volunteers were recruited for this study. The total distance of the marker which presents the center of mass displacement was measured using the camera - Kinovea®. The difference between with and without an elastic band was analyzed using the paired t-test with p < 0.05 as the significant level. Results The total distance of the center of mass was significantly decreased (p < 0.001) when one leg standing on an unstable surface with an elastic band versus without an elastic band. Conclusions The present findings demonstrate that using an elastic band on the first metatarsophalangeal joint and the ankle improves ankle stability during one leg standing on an unstable surface in healthy adults.

Comparison of Physical Examination Test Validity for Determining Clinical Decision Making of Lumbar Stabilization Exercise

Eui-Ryong Kim(Eui-Ryong Kim) 한국임상움직임치료학회 2022 한국임상움직임치료학회지 Vol.2 No.1

Background: As a high false positive rate of Imaging based on patholo-anatomical models, it is difficult to classify and diagnose patients and with asymptomatic with only diagnoses by imaging. To provide more accurate diagnoses, subjective information based on the patterns of pain should be obtained physical tests should be conducted together with diagnoses by imaging. However, there is no study to examine the validity of physical tests. Objectives: The purpose of this study was to investigate the sensitivity, specificity, prediction rates, and likelihood ratios for those who had been diagnosed with the herniation of intervertebral discs or degenerative vertebral diseases and those who had not been diagnosed with these diseases through radiology. Methods: A total of 211 subjects were recruited in this study, with 137 chronic low back pain group (58 males, 79 females) receiving a medical diagnosis and 74 healthy control group (34 males, 40 females) not receiving a medical diagnosis. Physical examination tests in this study were rated using a positive and negative categorical scale. Then, the sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+, LR-) of the physical examination and medical diagnosis between chronic LBP and control group also were determined. Results Active movement test is high sensitivity, specificity, positive and negative predictive, positive and negative likelihood ratio than passive movement test. As increased age, the sensitivity was higher in passive movement test. Conclusions: The prone instability test (PIT), the active straight leg raise (ASLR), and the active hip abduction test (AHAT) are considered to be useful in diagnostic tests of chronic low back pain patients in clinics, and in particular, these tests are more sensitive to elderly persons aged 60 years or more.

플립-플롭(Flip-flops) 보행이 건강한 성인의 시-공간적 변수와 발목 관절 움직임에 미치는 영향

장예은(Ye-Eun Jang),김하경(Ha-Kyung Kim),김정은(Jung-Eun Kim),김예담(Ye-Dam Kim),유승연(Seung-Yeon Yu),박재영(Jae-Yeong Park),김동우(Dong-Woo Kim),오재섭(Jae-Seop Oh) 한국임상움직임치료학회 2022 한국임상움직임치료학회지 Vol.2 No.1

Background: The flip-flop, popular for its light design and convenience, has practical advantages, but is unstable compared to closed shoes. This feature of the flip-flop causes a change in walking patterns. In previous studies, there are many studies on the kinetic and kinematic characteristics of flip-flop walking; however, there are various conclusions on the effect of flip-flop walking on temporal and spatial parameters, and ankle motion change during flip-flop walking. Objectives: The purpose of this study was to investigate the effect of flip-flop walking on spatio-temporal variables and ankle motion compared to sneakers walking. Methods: Twenty-one healthy subjects were participated. Xsens-DOT was used to track body movements. Steplab was used to analyze, visualize, and quantify tracked data. Participants were instructed to walk naturally in sneakers that fit their feet, and 50 steps were measured, five steps later for adaptation. In the same way, the measurement was performed wearing flip flops. The paired t-test was used to investigate the difference between sneakers walking and flip-flop gait. Statistical significance levels were set to α = 0.05. Results: There was no statistically significant difference in walking speed and stride length in spatio- temporal parameter. However, compared to sneakers walking, the maximum toe distance during flip-flop walking decreased statistically significantly (p < 0.05). The ankle motion was significantly reduced in both toe off angle and heel contact angle during flip-flop walking (p < 0.05). Conclusions: Walking wearing flip-flops increases the risk of falls and reduces push off capacity. Therefore, people who are fatal to falls and vulnerable to fatigue should not walk wearing flip-flops.

압력 생체 되먹임 장비를 이용한 깊은 목 굽힘근의 근력 및 지구력 측정 시 시각적 피드백 유무에 따른 검사-재검사 신뢰도 연구

성진욱(Jin-Wook Sung),어인준(In-Joon Uh),조원녕(Won-Nyeong Cho),고민주(Min-Joo Ko) 한국임상움직임치료학회 2022 한국임상움직임치료학회지 Vol.2 No.1

Background: The maximum voluntary contractile strength (MVCS) and sustained time at 50% submaximal voluntary contractile strength (SMVCS) using a pressure biofeedback unit have been used to measure the muscle strength and endurance of deep neck flexor muscles. However, to date, there has been no test-retest reliability study for this measurement method. Objectives: The purpose of this study was to measure the test-retest reliability of muscle strength and endurance of deep neck flexor using a pressure biofeedback unit, with and without visual feedback. Methods: Thirty healthy subjects were recruited for this study. Muscle strength and endurance of deep neck flexor were measured by pressure biofeedback unit and stopwatch. Intra-rater reliability of the deep neck flexor strength and endurance was analyzed using intraclass correlation coefficients (ICC 3, 1). Furthermore, the paired t-test was used to compare the sustained time of SMVCS of deep neck flexor between with and without visual feedback. Results: For MVCS, the value of ICC with (ICC: 0.965) and without visual feedback (ICC: 0.892) were both excellent. For the sustained time of SMVCS, the value of ICC with visual feedback were excellent (ICC: 0.910) while without visual feedback was fair to good (ICC: 0.654). Additionally, the sustained time of SMVCS of deep neck flexor was significantly greater with visual feedback than without visual feedback (p < 0.05). Conclusions: The measurement of strength and endurance using a pressure biofeedback unit with visual feedback can be recommended for reliable measurement of deep neck flexor muscle. Furthermore, the pressure biofeedback unit with visual feedback may be an effective method to increase the endurance of deep neck flexor muscles.

위등세모근 통증유발점이 있는 목 통증 환자의 압력 통각 역치 및 근활성도에 대한 뉴렉 기법의 즉각적인 효과

하용목(Yong-Mok Ha),어인준(In-Joon Uh),손정호(Jung-Ho Son),신선실(Sun-Shil Shin) 한국임상움직임치료학회 2023 한국임상움직임치료학회지 Vol.3 No.2

Background Neck pain is a prevalent condition affecting 45-54% of the population, with chronic symp-toms experienced by 14% of individuals, leading to significant productivity reduction and healthcare costs. Therapeutic exercise, particularly active interventions, has shown efficacy in reducing chronic neck pain. The Neurac (Neuromuscular Activation) technique aims to enhance active movement and create pain-free movement. Objectives To investigate the immediate effects of Neurac technique on pressure pain threshold (PPT), resting muscle activity measured through surface electromyography (sEMG), and pain level assessed using the Visual Analogue Scale (VAS) in individuals with chronic neck pain. Methods Fifteen adult participants with chronic neck pain were recruited from a university in Busan, South Korea. Neurac technique, involving four specific neck, and shoulder exercises using a Redcord Trainer, PPT, resting muscle activity, and pain level (VAS) were evaluated before and after the Neurac technique intervention. Results Following the Neurac technique, participants demonstrated a significant increase in PPT (p < 0.001) and a significant decrease in pain level measured by VAS scores (p < 0.001), indicating reduced pain. However, no significant changes were observed in resting muscle activity during the rest period (p = 0.616). Conclusions This study found that the Neurac treatment program effectively reduced pain and in-creased pressure pain threshold in individuals with neck pain associated with trigger points in the upper trapezius muscle, although no significant changes in muscle activity at rest were observed.

레이저빔을 이용한 시각적 생체 되먹임이 전방 런지운동 시 안쪽넓은근과 가쪽넓 은근의 근 활성도에 미치는 영향

공치완(Chi-Wan Kong),오재섭(Jae-Seop Oh),김미현(Mi-Hyun Kim),안덕현(Duk-Hyun An),성진욱(Jin-Wook Sung) 한국임상움직임치료학회 2021 한국임상움직임치료학회지 Vol.1 No.1

Background : Knee pain is a common musculoskeletal concern that inconveniences daily life. A recent study revealed that knee pain occurs mainly when the knees are not aligned correctly during weight load training. Certain visual biofeedback methods enable the strengthening of the vastus medialis (VMO) muscle, whose activity keeps the lower limb in neutral alignment. However, the visual biofeedback devices in most studies are hard to use, and only a few have suggested methods for selective VMO strengthening using laser equipment during weight-bearing tasks. Objectives : The purpose of this study was to measure the electromyographic VMO and vastus lateralis (VL) activity during forward lunge with and without biofeedback. Methods : Twenty subjects with a healthy participated in this study. VMO and VL activity between forward lunges with and without visual biofeedback using a laser beam was compared. The VMO, VL, and VMO/VL muscle activity ratios with and without visual biofeedback were analyzed using paired t-tests with p < 0.05 as the significance level. Results : The VMO muscle activity was significantly higher (p = 0.020) during the forward lunge with visual biofeedback than that in the forward lunge without feedback. The VL muscle activity was decreased but not significantly (p < 0.05). The VMO/VL muscle activity ratio was significantly higher (p < 0.05) during the forward lunge with visual biofeedback than that in the forward lunge without biofeedback. Conclusions : In this study, there were significant increases in VMO muscle activity and VMO/VL muscle activity ratio with biofeedback. The results show that the use of laser equipment for visual biofeedback can affect selective muscle activation, and the visual biofeedback equipment can be useful in treatment or development of protocols for the performance of weight-bearing exercises or exercises intended to prevent knee injury.

뒤통수밑근 근막이완기법이 전방머리자세 환자의 머리척추각과 상부 목 굽힘 각도에 미치는 영향

장예은(Ye-Eun Jang),전지형(Ji-Hyeong Jeon),문성욱(Seong-Wook Moon),서해니(Hae-Ni Seo),유일영(Il-Young Yu) 한국임상움직임치료학회 2023 한국임상움직임치료학회지 Vol.3 No.2

Background Forward head posture (FHP) is a representative disease of modern society, and it is closely related to the suboccipital muscle. However, there is little study that suboccipital myofascial release af-fect on the cranio-vertebral angle (CVA) and upper cervical flexion angle. Objectives The purpose of this study is to investigate the immediate effect of suboccipital myofascial release on the CVA and upper cervical flexion angle in patients with FHP Methods The subjects were 19 patients with FHP. The CVA and upper cervical flexion angle were measured before and after applying a 15-minute myofascial release to the suboccipital muscles. The CVA and upper cervical flexion angle were assessed using the Kinovea program. The difference before and after myofascial release was analyzed using a paired t-test. Results As a result of applying myofascial release on suboccipital muscles for 15 minutes to patients with a forward heard posture, there was a significant increase in the CVA and the upper cervical flexion angle (p < 0.05). Conclusions Myofascial release on suboccipital muscles is an effective treatment method for improv-ing FHP and restoring upper cervical movement in patients with FHP.

AB-슬라이드를 이용한 월슬라이드 운동이 앞톱니근과 위등세모근의 근활성도에 미치는 영향

박문조(Mun-Jo Park),유원규(Won-Gyu Yoo),안덕현(Duk-Hyun An),서종길(Jong-Gil Seo),오재섭(Jae-Seop Oh) 한국임상움직임치료학회 2023 한국임상움직임치료학회지 Vol.3 No.2

Background It is known that a wall slide exercise is required to strengthen the serratus anterior. However, overactivation of the upper trapezius during wall slide exercise reduces serratus anterior mus-cle activation. Currently, methods to strengthen the serratus anterior muscle during wall slide exercise are being studied. However, there is no study that wall slide exercise using AB-SLIDE the affects upper trapezius and serratus anterior muscle. Objectives The purpose of this study is to compare the upper trapezius and serratus anterior muscle activity between general wall slide exercise and wall slide exercise using AB-SLIDE. Methods A total of 15 healthy male volunteers were recruited for this study. With and without AB-SLIDE, muscle activity of the upper trapezius and serratus anterior was compared during the wall slide exercise. The electromyographic data of the upper trapezius and serratus anterior was measured using 4D-MT, 2EM. The difference between general wall slide and wall slide using AB-SLIDE was ana-lyzed using the paired t-test with p < 0.05 as a significant level. Results Compared to the general wall slide exercise the upper trapezius muscle activation was sig-nificantly decreased when wall slide exercise using AB-SLIDE(p < 0.05). Also, serratus anterior muscle activation was significantly increased when wall slide exercise using AB-SLIDE (p < 0.05). Conclusions In this study, compared to general wall slide exercise, the upper trapezius muscle activity was significantly decreased and serratus anterior muscle activity significantly increased when using AB-SLIDE. The result of this study can confirm the wall slide exercise using AB-SLIDE will be a useful way to increase the muscle activity of the serratus anterior.